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Maximilian F Reiser - One of the best experts on this subject based on the ideXlab platform.

  • impact of cardiovascular risk factors on vessel wall inflammation and calcified Plaque Burden differs across vascular beds a pet ct study
    International Journal of Cardiovascular Imaging, 2013
    Co-Authors: Frederik F Strobl, Fabian Bamberg, Axel Rominger, Sarah Wolpers, Konstantin Nikolaou, Carsten Rist, Kolja M Thierfelder, Christopher Uebleis, Marcus Hacker, Maximilian F Reiser
    Abstract:

    To evaluate the effect of age, gender and cardiovascular risk factors on vessel wall inflammation and the calcified Plaque Burden in different vascular beds as assessed by PET/CT. 315 patients (mean age: 57.8 years, 123 male and 192 female) who underwent whole body 18F-FDG PET/CT examinations were included in the study. Blood pool-corrected standardised uptake value (TBR) and the calcified Plaque score (CPS, grade 0–4) were determined in the thoracic and abdominal aorta, both common carotid and both iliac arteries. The following cardiovascular risk factors were documented: Age ≥65 years (n = 114), male gender (n = 123), diabetes (n = 15), hyperlipidemia (n = 62), hypertension (n = 76), body mass index (BMI) ≥ 30 (n = 38), current smoker (n = 32). Effects of risk factors on TBR and CPS in different arterial beds were assessed using multivariate regression analysis. In the thoracic aorta TBR was independently associated with age ≥65 years and male gender, CPS was independently associated with age ≥65 years, male gender, hypertension and diabetes. In the abdominal aorta, TBR was independently associated with age ≥65 years and male gender, CPS with age ≥65 years, diabetes and smoking. Independent associations in the carotid arteries were found for age ≥65 years, male gender and BMI ≥ 30 in TBR and for age ≥65 and diabetes in CPS. In the iliac arteries, TBR was independently associated with age ≥65 and CPS with age ≥65, male gender, hypertension, diabetes and smoking. Findings of this PET/CT study demonstrate that the impact of cardiovascular risk factors on vessel wall inflammation and calcified Plaque Burden differs across vascular territories. Overall, CPS was more closely associated with cardiovascular risk factors compared to TBR.

  • association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors Plaque Burden and pericardial fat volume a pet ct study
    European Journal of Nuclear Medicine and Molecular Imaging, 2010
    Co-Authors: Tobias Saam, Axel Rominger, Sarah Wolpers, Konstantin Nikolaou, C Rist, Martin Greif, Paul Cumming, Alexander Becker, Stefan Foerster, Maximilian F Reiser
    Abstract:

    Purpose Measurements of [18F]fluorodeoxyglucose (FDG) uptake as a potential marker of the inflammatory activity of the vessel wall could be useful to identify vulnerable atherosclerotic Plaques. The purpose of this study was to correlate the FDG uptake in the left anterior descending coronary artery (LAD) with cardiovascular risk factors, pericardial fat volume (PFV) and calcified Plaque Burden (CPB).

  • association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors Plaque Burden and pericardial fat volume a pet ct study
    European Journal of Nuclear Medicine and Molecular Imaging, 2010
    Co-Authors: Tobias Saam, Axel Rominger, Sarah Wolpers, Konstantin Nikolaou, Martin Greif, Paul Cumming, Alexander Becker, Stefan Foerster, Carsten Rist, Maximilian F Reiser
    Abstract:

    Measurements of [18F]fluorodeoxyglucose (FDG) uptake as a potential marker of the inflammatory activity of the vessel wall could be useful to identify vulnerable atherosclerotic Plaques. The purpose of this study was to correlate the FDG uptake in the left anterior descending coronary artery (LAD) with cardiovascular risk factors, pericardial fat volume (PFV) and calcified Plaque Burden (CPB). A total of 292 consecutive tumour patients were examined by whole-body FDG PET and contrast-enhanced CT. The blood pool-corrected standardized uptake value (target to background ratio, TBR) was measured in the LAD, and the contrast-enhanced CT images were used to measure the PFV and the CPB. The Spearman correlation coefficient and the unpaired t test were used for statistical comparison between image-based results and cardiovascular risk factors. Vascular FDG uptake could be measured for 161 of 292 (55%) patients without myocardial uptake, but the vessel uptake could not be distinguished in the other patients, due to pervasive myocardial uptake. The TBR of the LAD showed significant correlations with hypertension (R = 0.18; p < 0.05), coronary heart disease (R = 0.19; p < 0.05), body mass index (BMI) (R = 0.19; p < 0.05), CPB (R = 0.36; p < 0.001) and PFV (R = 0.20; p < 0.05), but not with other risk factors. Patients with a TBR in the upper tertile had a larger CPB and a higher PFV than patients with a TBR in the lower tertile (9.1 vs 3.5; p < 0.001 for CPB and 92.2 vs 71.5 mm3; p < 0.05 for PVF). FDG uptake measurement in the LAD correlates with hypertension, coronary heart disease, BMI, PFV and CPB. However, due to myocardial FDG uptake these measurements are only feasible in one half of the patients.

Daniel S Berman - One of the best experts on this subject based on the ideXlab platform.

  • repeatability of quantitative pericoronary adipose tissue attenuation and coronary Plaque Burden from coronary ct angiography
    Journal of Cardiovascular Computed Tomography, 2020
    Co-Authors: Evangelos Tzolos, Priscilla Mcelhinney, Michelle C Williams, Sebastien Cadet, M R Dweck, Daniel S Berman, Piotr J Slomka, David E Newby, Damini Dey
    Abstract:

    Abstract Background High pericoronary adipose tissue (PCAT) attenuation and non-calcified Plaque Burden (NCP) measured from coronary CT angiography (CTA) have been implicated in future cardiac events. We aimed to evaluate the interobserver and intraobserver repeatability of PCAT attenuation and NCP Burden measurement from CTA, in a sub-study of the prospective SCOT-HEART trial. Methods Fifty consecutive CTAs from participants of the CT arm of the prospective SCOT-HEART trial were included. Two experienced observers independently measured PCAT attenuation and Plaque characteristics throughout the whole coronary tree from CTA using semi-automatic quantitative software. Results We analyzed proximal segments in 157 vessels. Intraobserver mean differences in PCAT attenuation and NCP Plaque Burden were −0.05HU and 0.92% with limits of agreement (LOA) of ±1.54 and ± 5.97%. Intraobserver intraclass correlation coefficients (ICC) for PCAT attenuation and NCP Burden were excellent (0.999 and 0.978). Interobserver mean differences in PCAT attenuation and NCP Plaque Burden were 0.13HU [LOA ±1.67HU] and −0.23% (LOA ±9.61%). Interobserver ICC values for PCAT attenuation and NCP Burden were excellent (0.998 and 0.944). Conclusion PCAT attenuation and NCP Burden on CTA has high intraobserver and interobserver repeatability, suggesting they represent a repeatable and robust method of quantifying cardiovascular risk.

  • predictive value of age and sex specific nomograms of global Plaque Burden on coronary computed tomography angiography for major cardiac events
    Circulation-cardiovascular Imaging, 2017
    Co-Authors: Christopher Naoum, Daniel S Berman, Amir Ahmadi, Jagat Narula, Heidi Gransar, Stephan Achenbach, Philipp Blanke, Leslee J Shaw, Leonard Kritharides, Mouaz H Almallah
    Abstract:

    Background— Age-adjusted coronary artery disease (CAD) Burden identified on coronary computed tomography angiography predicts major adverse cardiovascular event (MACE) risk; however, it seldom contributes to clinical decision making because of a lack of nomographic data. We aimed to develop clinically pragmatic age- and sex-specific nomograms of CAD Burden using coronary computed tomography angiography and to validate their prognostic use. Methods and Results— Patients prospectively enrolled in phase I of the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes) were included (derivation cohort: n=21,132; 46% female) to develop CAD nomograms based on age–sex percentiles of segment involvement score (SIS) at each year of life (40–79 years). The relationship between SIS age–sex percentiles (SIS%) and MACE (all-cause death, myocardial infarction, unstable angina, and late revascularization) was tested in a nonoverlapping validation cohort (phase II, CONFIRM registry; n=3030, 44% female) by stratifying patients into 3 SIS% groups (≤50th, 51–75th, and >75th) and comparing annualized MACE rates and time to MACE using multivariable Cox proportional hazards models adjusting for Framingham risk and chest pain typicality. Age–sex percentiles were well fitted to second-order polynomial curves (men: R 2 =0.86±0.12; women: R 2 =0.86±0.14). Using the nomograms, there were 1576, 965, and 489 patients, respectively, in the ≤50th, 51–75th, and >75th SIS% groups. Annualized event rates were higher among patients with greater CAD Burden (2.1% [95% confidence interval: 1.7%–2.7%], 3.9% [95% confidence interval: 3.0%–5.1%], and 7.2% [95% confidence interval: 5.4%–9.6%] in ≤50th, 51–75th, and >75th SIS% groups, respectively; P 75th SIS% group; P Conclusions— We have developed clinically pragmatic age- and sex-specific nomograms of CAD prevalence using coronary computed tomography angiography findings. Global Plaque Burden measured using SIS% is predictive of cardiac events independent of traditional risk assessment. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT01443637.

  • editorial commentary coronary Plaque Burden regression and high risk Plaque reversal potential biomarkers for secondary prevention
    Trends in Cardiovascular Medicine, 2016
    Co-Authors: Janet Wei, Daniel S Berman
    Abstract:

    Approximately 300,000 Americans have a recurrent coronary attack each year [1]. Effective medical therapies reduce event frequency, and newer, potentially more effective anti-atherosclerotic therapies are being studied [2–4] and becoming available [5,6]. The therapeutic implications of these novel agents are likely to have significant expense and some significant risk such that their appropriate selection for the individual patient will become increasingly important. A question that arises is whether in-vivo coronary Plaque assessment can appropriately select high-risk patients for this therapy and monitor treatment response. In the article “Regression of Coronary Atherosclerosis: Current Evidence and Future Perspectives”, Koskinas et al. [7] reviewed intracoronary imaging modalities for the evaluation of Plaque Burden and morphology. The authors conclude that while there is currently insufficient data to demonstrate the impact of Plaque regression or stabilization on reducing coronary events, in-vivo Plaque evaluation may ultimately help identify high-risk patients who will benefit from novel aggressive anti-atherosclerotic therapy. They summarize current evidence of coronary Plaque regression and stabilization with intensive anti-atherosclerotic therapy using intravascular ultrasound (IVUS), optical coherence tomography, and near infrared spectroscopy. These intracoronary imaging modalities have allowed investigators to quantify Plaque Burden, characterize high-risk Plaque, and assess Plaque responses to therapy. The authors note atheroma volume, fibrous cap thickness, arterial remodeling, lipid pool/necrotic core, and macrophage accumulation to be important characteristics. However, catheter-based intracoronary imaging has demonstrated only modest changes with anti-atherosclerotic therapy, as detailed by the authors. Hybrid noninvasive coronary Plaque imaging may be needed to help us understand the discordance between the substantial clinical impact of statins vs their modest Plaque regression and minor changes in Plaque morphology. Advances in noninvasive coronary Plaque imaging may bridge this knowledge gap, as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) can also evaluate Plaque Burden and/or high-risk Plaque morphology, although each has its limitations (Table). Table Comparison of CT, MRI, and PET for assessment of coronary Plaque morphology and composition.

  • automated quantitative Plaque Burden from coronary ct angiography noninvasively predicts hemodynamic significance by using fractional flow reserve in intermediate coronary lesions
    Radiology, 2015
    Co-Authors: Mariana Diazzamudio, Daniel S Berman, Piotr J Slomka, Jagat Narula, Annika Schuhbaeck, Ryo Nakazato, Heidi Gransar, Stephan Achenbach
    Abstract:

    Automatic quantification of total, noncalcified, and low-attenuation noncalcified Plaque Burden at coronary CT angiography significantly improves determination of hemodynamic significance by using fractional flow reserve in patients with intermediate coronary lesions.

  • comparison of quantitative atherosclerotic Plaque Burden from coronary ct angiography in patients with first acute coronary syndrome and stable coronary artery disease
    Journal of Cardiovascular Computed Tomography, 2014
    Co-Authors: Damini Dey, Daniel S Berman, Piotr J Slomka, Annika Schuhbaeck, Ryo Nakazato, Stephan Achenbach, Tobias Pflederer, Mohamed Marwan
    Abstract:

    Abstract Background Coronary CTA allows characterization of non-calcified and calcified Plaque and identification of high-risk Plaque features. Objective We aimed to quantitatively characterize and compare coronary Plaque Burden from CTA in patients with a first acute coronary syndrome (ACS) and controls with stable coronary artery disease. Materials and methods We retrospectively analyzed consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina with a first ACS, who underwent CTA as part of their initial workup before invasive coronary angiography and age- and gender-matched controls with stable chest pain; controls also underwent CTA with subsequent invasive angiography (total n = 28). Culprit arteries were identified in ACS patients. Coronary arteries were analyzed by automated software to quantify calcified Plaque (CP), noncalcified Plaque (NCP), and low-density NCP (LD-NCP, attenuation Results ACS patients had fewer lesions (median, 1), with higher total NCP and LD-NCP Burdens (NCP: 57.4% vs 41.5%; LD-NCP: 12.5% vs 8%; P ≤ .04), higher maximal stenoses (85.6% vs 53.0%; P  = .003) and contrast density differences (46.1 vs 16.3%; P P ≤ .0003); CP was not significantly different. Culprit arteries had increased Plaque lengths, remodeling indices, stenoses, and contrast density differences (46.1% vs 10.9%; P ≤ .001). Conclusion Noninvasive quantitative coronary artery analysis identified several differences for ACS, both on per-patient and per-vessel basis, including increased NCP, LD-NCP Burden, and contrast density difference.

David A Bluemke - One of the best experts on this subject based on the ideXlab platform.

  • abstract p212 reduced high density lipoprotein efflux in psoriasis relates to increased coronary Plaque Burden by quantitative ct angiography
    Circulation, 2015
    Co-Authors: Taufiq Salahuddin, David A Bluemke, Mariana Selwaness, Martin P Playford, Balaji Natarajan, Ahmed Sadek, Julia Doveikis, Nehal N. Mehta
    Abstract:

    INTRODUCTION: Psoriasis is known to increase cardiovascular risk, possibly due to the presence of inflammatory, lipid-rich, non-calcified Plaques in the coronary arteries. Psoriasis is also known to decrease HDL activity. However, whether having abnormal or low-functioning HDL increases arterial disease is currently unknown. HYPOTHESIS: We aimed to test our hypothesis that coronary Plaque Burden assessed by quantitative CT angiography is related to HDL efflux capacity and other cardiometabolic parameters in a well-phenotyped psoriasis cohort (NCT# 01778569). METHODS: Psoriasis patients (N=67) underwent coronary CT angiography (Toshiba 320 slice). Coronary Plaque was assessed using QAngio CT (Medis, The Netherlands). Total (TB), dense calcium (DCB), and non-calcified Burden (NCB) Plaque indices were calculated by dividing total vessel Plaque volume by total vessel length. We also performed deep phenotyping for lipid markers including HDL efflux capacity and other cardiometabolic parameters. RESULTS: The study population was middle aged (52.2 ± 12.4 yr), had relatively low Framingham Risk Score (median 4%, IQR 2-7%), and had normal Apo A1 (156 ± 26.3 mg/dL) and HDL levels (54 ± 17 mg/dL). However, HDL efflux capacity was similar to that in coronary artery disease (0.95 ± 0.17). In univariate regression, NCB increased as HDL efflux capacity decreased (β= -0.84, p=0.01) and was robust to adjustment for cardiometabolic risk factors (β= -0.67, p=0.03). Furthermore, when stratified by median HDL efflux (0.94), patients having lower HDL efflux capacity had higher TB and NCB (TB 3.80 ± 0.82, 4.17 ± 0.97 mm2, p=0.003; NCB 3.59 ± 0.68, 3.94 ± 0.75 mm2, p=0.001 in the low and high HDL efflux groups, respectively). Additional biologic relations in univariate regression are shown in Table 1. CONCLUSIONS: We show that HDL efflux is negatively associated with coronary Plaque Burden measured by quantitative CT angiography. Low HDL efflux may therefore be a strong biomarker for subclinical coronary atherosclerosis. ![][1] [1]: /embed/graphic-1.gif

  • Beyond Coronary Stenosis: Coronary Computed Tomographic Angiography for the Assessment of Atherosclerotic Plaque Burden
    Current Cardiovascular Imaging Reports, 2013
    Co-Authors: Alan C. Kwan, George Cater, Jose Vargas, David A Bluemke
    Abstract:

    Coronary computed tomographic angiography (CCTA) is emerging as a key noninvasive method for assessing cardiovascular risk by measurement of coronary stenosis and coronary artery calcium (CAC). New advancements in CCTA technology have led to the ability to directly identify and quantify the so-called “vulnerable” Plaques that have features of positive remodeling and low density components. In addition, CCTA presents a new opportunity for noninvasive measurement of total coronary Plaque Burden that has not previously been available. The use of CCTA needs also to be balanced by its risks; in particular, the associated radiation exposure. We review current uses of CCTA, CCTA’s ability to measure Plaque quantity and characteristics, and new developments in risk stratification and CCTA technology. CCTA represents a quickly developing field that will play a growing role in the non-invasive management of cardiovascular disease.

  • the association of pericardial fat with coronary artery Plaque index at mr imaging the multi ethnic study of atherosclerosis mesa
    Radiology, 2011
    Co-Authors: Cuilian Miao, Jingzhong Ding, Joao A C Lima, Shaoguang Chen, Robson Macedo, Jens Vogelclaussen, Elizabeth R Brown, David A Bluemke, Debiao Li
    Abstract:

    Pericardial fat volume was associated with coronary atherosclerotic Plaque Burden in asymptomatic individuals, and the relationship between pericardial fat volume and Plaque Burden was stronger in men than in women.

Tobias Saam - One of the best experts on this subject based on the ideXlab platform.

  • association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors Plaque Burden and pericardial fat volume a pet ct study
    European Journal of Nuclear Medicine and Molecular Imaging, 2010
    Co-Authors: Tobias Saam, Axel Rominger, Sarah Wolpers, Konstantin Nikolaou, C Rist, Martin Greif, Paul Cumming, Alexander Becker, Stefan Foerster, Maximilian F Reiser
    Abstract:

    Purpose Measurements of [18F]fluorodeoxyglucose (FDG) uptake as a potential marker of the inflammatory activity of the vessel wall could be useful to identify vulnerable atherosclerotic Plaques. The purpose of this study was to correlate the FDG uptake in the left anterior descending coronary artery (LAD) with cardiovascular risk factors, pericardial fat volume (PFV) and calcified Plaque Burden (CPB).

  • association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors Plaque Burden and pericardial fat volume a pet ct study
    European Journal of Nuclear Medicine and Molecular Imaging, 2010
    Co-Authors: Tobias Saam, Axel Rominger, Sarah Wolpers, Konstantin Nikolaou, Martin Greif, Paul Cumming, Alexander Becker, Stefan Foerster, Carsten Rist, Maximilian F Reiser
    Abstract:

    Measurements of [18F]fluorodeoxyglucose (FDG) uptake as a potential marker of the inflammatory activity of the vessel wall could be useful to identify vulnerable atherosclerotic Plaques. The purpose of this study was to correlate the FDG uptake in the left anterior descending coronary artery (LAD) with cardiovascular risk factors, pericardial fat volume (PFV) and calcified Plaque Burden (CPB). A total of 292 consecutive tumour patients were examined by whole-body FDG PET and contrast-enhanced CT. The blood pool-corrected standardized uptake value (target to background ratio, TBR) was measured in the LAD, and the contrast-enhanced CT images were used to measure the PFV and the CPB. The Spearman correlation coefficient and the unpaired t test were used for statistical comparison between image-based results and cardiovascular risk factors. Vascular FDG uptake could be measured for 161 of 292 (55%) patients without myocardial uptake, but the vessel uptake could not be distinguished in the other patients, due to pervasive myocardial uptake. The TBR of the LAD showed significant correlations with hypertension (R = 0.18; p < 0.05), coronary heart disease (R = 0.19; p < 0.05), body mass index (BMI) (R = 0.19; p < 0.05), CPB (R = 0.36; p < 0.001) and PFV (R = 0.20; p < 0.05), but not with other risk factors. Patients with a TBR in the upper tertile had a larger CPB and a higher PFV than patients with a TBR in the lower tertile (9.1 vs 3.5; p < 0.001 for CPB and 92.2 vs 71.5 mm3; p < 0.05 for PVF). FDG uptake measurement in the LAD correlates with hypertension, coronary heart disease, BMI, PFV and CPB. However, due to myocardial FDG uptake these measurements are only feasible in one half of the patients.

Udo Hoffmann - One of the best experts on this subject based on the ideXlab platform.

  • quantitative coronary Plaque analysis predicts high risk Plaque morphology on coronary computed tomography angiography results from the romicat ii trial
    International Journal of Cardiovascular Imaging, 2018
    Co-Authors: Stefan Puchner, Pieter H Kitslaar, Pal Maurovichhorvat, Thomas Mayrhofer, Michael T Lu, Khristine Ghemigian, Alexander Broersen, Amit Pursnani, Udo Hoffmann
    Abstract:

    Semi-automated software can provide quantitative assessment of atherosclerotic Plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk Plaque features and quantitative Plaque measurements has not been studied. We analyzed the association between quantitative Plaque measurements and qualitative high-risk Plaque features on coronary CTA. We included 260 patients with Plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative Plaque assessment and qualitative Plaque characterization were performed on a per coronary segment basis. Quantitative coronary Plaque measurements included Plaque volume, Plaque Burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk Plaque was present if positive remodeling, low CT attenuation Plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk Plaque assessment. Among 888 segments with coronary Plaque, high-risk Plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk Plaque had higher total Plaque volume, low CT attenuation Plaque volume, Plaque Burden and remodeling index. Quantitatively assessed low CT attenuation Plaque volume (odds ratio 1.12 per 1 mm3, 95% CI 1.04–1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10–1.41) and Plaque Burden (odds ratio 1.53 per 0.1, 95% CI 1.08–2.16) were associated with high-risk Plaque. Quantitative coronary Plaque characteristics (low CT attenuation Plaque volume, positive remodeling and Plaque Burden) measured by semi-automated software correlated with qualitative assessment of high-risk Plaque features.

  • iterative image reconstruction improves the accuracy of automated Plaque Burden assessment in coronary ct angiography a comparison with intravascular ultrasound
    American Journal of Roentgenology, 2017
    Co-Authors: Akiko Maehara, Gary S Mintz, Stefan Puchner, Maros Ferencik, Paul Stolzmann, Hansulrich Kauczor, Udo Hoffmann, Christopher L Schlett
    Abstract:

    OBJECTIVE. The purpose of this study was to determine whether use of iterative image reconstruction algorithms improves the accuracy of coronary CT angiography (CCTA) compared with intravascular ultrasound (IVUS) in semiautomated Plaque Burden assessment. MATERIALS AND METHODS. CCTA and IVUS images of seven coronary arteries were acquired ex vivo. CT images were reconstructed with filtered back projection (FBP) and adaptive statistical (ASIR) and model-based (MBIR) iterative reconstruction algorithms. Cross-sectional images of the arteries were coregistered between CCTA and IVUS in 1-mm increments. In CCTA, fully automated (without manual corrections) and semiautomated (allowing manual corrections of vessel wall boundaries) Plaque Burden assessments were performed for each of the reconstruction algorithms with commercially available software. In IVUS, Plaque Burden was measured manually. Agreement between CCTA and IVUS was determined with Pearson correlation. RESULTS. A total of 173 corresponding cross se...

  • variability and accuracy of coronary ct angiography including use of iterative reconstruction algorithms for Plaque Burden assessment as compared with intravascular ultrasound an ex vivo study
    European Radiology, 2012
    Co-Authors: Paul Stolzmann, Akiko Maehara, Gary S Mintz, Christopher L Schlett, Pal Maurovichhorvat, Hans Scheffel, Leifchristopher Engel, Mihaly Karolyi, Udo Hoffmann
    Abstract:

    To systematically assess inter-technique and inter-/intra-reader variability of coronary CT angiography (CTA) to measure Plaque Burden compared with intravascular ultrasound (IVUS) and to determine whether iterative reconstruction algorithms affect variability. IVUS and CTA data were acquired from nine human coronary arteries ex vivo. CT images were reconstructed using filtered back projection (FBPR) and iterative reconstruction algorithms: adaptive-statistical (ASIR) and model-based (MBIR). After co-registration of 284 cross-sections between IVUS and CTA, two readers manually delineated the cross-sectional Plaque area in all images presented in random order. Average Plaque Burden by IVUS was 63.7 ± 10.7% and correlated significantly with all CTA measurements (r = 0.45–0.52; P   0.05). Increased overestimation was associated with smaller Plaques, eccentricity and calcification (P   0.05). In ex vivo coronary arteries, Plaque Burden by coronary CTA had extremely low inter-/intra-reader variability and correlated significantly with IVUS measurements. Accuracy as well as reader reliability were independent of CT image reconstruction algorithm. • IVUS is deemed the gold standard in-vivo coronary Plaque assessment • But coronary CT angiography findings correlate strongly with IVUS results • Coronary CT angiography now allows Plaque quantification close to IVUS • Iterative image reconstruction algorithms do not alter accuracy or reproducibility • Plaque quantification is more challenging in smaller eccentric calcified lesions

  • association of aortic valve calcification to the presence extent and composition of coronary artery Plaque Burden from the rule out myocardial infarction using computer assisted tomography romicat trial
    American Heart Journal, 2009
    Co-Authors: Amir A Mahabadi, Udo Hoffmann, Christopher L Schlett, Ian S Rogers, Michael Toepker, Thomas J Brady, Fabian Bamberg, John T Nagurney, Quynh A Truong
    Abstract:

    Background Aortic valve calcification (AVC) is associated with cardiovascular risk factors and coronary artery calcification. We sought to determine whether AVC is associated with the presence and extent of overall Plaque Burden, as well as to Plaque composition (calcified, mixed, and noncalcified). Methods We examined 357 subjects (mean age 53 ± 12 years, 61% male) who underwent contrast-enhanced electrocardiogram-gated 64-slice multidetector computed tomography from the ROMICAT trial for the assessment of presence and extent of coronary Plaque Burden according to the 17-coronary segment model and presence of AVC. Results Patients with AVC (n = 37, 10%) were more likely than those without AVC (n = 320, 90%) to have coexisting presence of any coronary Plaque (89% vs 46%, P P 3-fold increase odds of having any Plaque (adjusted odds ratio [OR] 3.6, P = .047) and an increase of 2.5 segments of Plaque ( P P = .004), then mixed Plaque (OR 3.2, P = .02), but not with noncalcified Plaque ( P = .96). Conclusion Aortic valve calcification is associated with the presence and greater extent of coronary artery Plaque Burden and may be part of the later stages of the atherosclerosis process, as its relation is strongest with calcified Plaque, less with mixed Plaque, and nonsignificant with noncalcified Plaque. If AVC is present, consideration for aggressive medical therapy may be warranted.

  • association between diabetes and different components of coronary atherosclerotic Plaque Burden as measured by coronary multidetector computed tomography
    Atherosclerosis, 2009
    Co-Authors: Christopher L Schlett, Chunho Yun, Ian S Rogers, Quynh A Truong, Michael Toepker, Patrick Donnelly, Thomas J Brady, Udo Hoffmann
    Abstract:

    Objective The aim of the study was to assess differences in the presence, extent, and composition of coronary atherosclerotic Plaque Burden as detected by coronary multidetector computed tomography (MDCT) between patients with and without diabetes mellitus. Methods We compared coronary atherosclerotic Plaques (any Plaque, calcified [CAP], non-calcified [NCAP, and mixed Plaque [MCAP]]) between 144 symptomatic diabetic and non-diabetic patients (36 diabetics, mean age: 54.4+/-12, 64% females) who underwent coronary 64-slice MDCT (Siemens Medical Solutions, Forchheim, Germany) for the evaluation of acute chest pain but proven absence of myocardial ischemia. Results Patients with diabetes had a higher prevalence of any Plaque, CAP, MCAP, and NCAP (p=0.08, 0.07, 0.05, and 0.05, respectively) and a significantly higher extent of any Plaque, CAP, MCAP, and NCAP (3.8+/-4.2 vs. 2.0+/-3.2, p=0.01; 3.3+/-4.0 vs. 1.7+/-3.0, p=0.03; 1.4+/-2.6 vs. 0.6+/-1.5, p=0.03; and 1.9+/-3.0 vs. 1.0+/-1.9, p=0.03, respectively) as compared to controls. In addition, patients with diabetes had a significant higher prevalence of significant coronary artery stenosis (42% vs. 14%, p=0.0004) and an approximately 3.5-fold higher risk of significant coronary stenosis independent of the presence of hypertension and BMI (OR: 3.46, 95% CI: 1.37-8.74, p=0.009). Conclusion Patients with diabetes have an approximately 3.5-fold higher risk of coronary stenosis independent of other cardiovascular risk factors and an overall increased coronary atherosclerotic Plaque Burden.